NPIMap

Organization Active NPI

Simplified RX Inc

  • Community/Retail Pharmacy
  • Guthrie, OK
National Provider Identifier
1891278750
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
32-8282 Issued in OK
Legal business name
SIMPLIFIED RX INC
Doing business as
Cornwell Pharmacy
Practice address
102 W Noble Ave
Guthrie, OK 73044-3123
Phone
(405) 282-7800
Fax
(405) 282-2244
NPI assigned
Sep 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeffrey A Stewart
Title
Secretary/Treasurer
Phone
(918) 510-0648

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 32-8282 OK Primary
Compounding Pharmacy 3336C0004X 32-8282 OK
Long Term Care Pharmacy 3336L0003X 32-8282 OK
Specialty Pharmacy 3336S0011X 32-8282 OK

Addresses

Primary practice location

102 W Noble Ave
Guthrie, OK 73044-3123

Mailing address

102 W Noble Ave
Guthrie, OK 73044-3123
Phone (405) 282-7800

Other identifiers 1

IdentifierTypeStateIssuer
32-8282OtherOKSTATE BOARD LICENSE

Other names 1

  • Cornwell Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190912000356 OK Part B Supplier - Mass Immunization (Roster Biller Only) 9032448345 Practice locations: Guthrie, OK
O20200515001496 OK DME Supplier - Pharmacy 9032448345 Practice locations: Guthrie, OK

National Provider Directory

National Provider Directory
Tax ID family
Cornwell Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

102 W Noble Ave
Guthrie, OK 73044
Phone (405) 282-7800

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1891278750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W NOBLE AVE",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730443123",
            "telephone_number": "405-282-7800",
            "fax_number": "405-282-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W NOBLE AVE",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730443123",
            "telephone_number": "405-282-7800",
            "fax_number": "405-282-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLIFIED RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-07",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "918-510-0648"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "32-8282",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "OK",
            "license": "32-8282",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "OK",
            "license": "32-8282",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "OK",
            "license": "32-8282",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD LICENSE",
            "identifier": "32-8282",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornwell Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Guthrie, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.